Korean Circulation Journal

  • 제47권1호
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  • Pages.97-106
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  • 2017
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Early and Midterm Results Following Interventional Coarctoplasty: Evaluation of Variables That Can Affect the Results

  • Bassiri, Hossein Ali (Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences) ;
  • Abdi, Seifollah (Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences) ;
  • Shafe, Omid (Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences) ;
  • Sarpooshi, Javad (Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences)
  • 투고 : 2016.05.26
  • 심사 : 2016.10.18
  • 발행 : 2017.01.31
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: Stent coarctoplasty has been approved as the treatment of choice for adult patients with coarctation of the aorta. We have evaluated the early and midterm clinical and procedural results after interventional coarctoplasty. Also, variables that can affect these results were evaluated. Subjects and Methods: Gathering clinical, angiographic and procedural data, we evaluated the pre-specified outcomes, including procedural success, complications, the incidence of hypertension after coarctoplasty etc., after the procedure. The effect of pre-specified variables including aortic arch shape, coarctation type and etc. on the procedural result was evaluated. Results: Between February 2005 through March 2014, 133 stent coarctoplasty procedures were performed. Median age was 23.5 years old (interquartile range [IQR]:19-28), and 105 (71.9%) were male. Nearly all of the patients were undergone stent coarctoplasty, mostly with cheatham platinum (CP) stents. There was no association between aortic arch morphology and acute procedural complications. Balloon length more than 40 mm (p=0.028), aorta diameter at the site of Coarctation larger than 2.35 mm (p=0.008) was associated with higher rate of restenosis during follow-up. Comparison between the prevalence of hypertension (HTN) before and after coarctoplasty showed a significant reduction in the prevalence of HTN (117 [91.4%] vs. 95 [74.2%] p<0.001). Conclusion: Stent coarctoplasty is a low-risk procedure with favorable early and delayed outcomes. Most mortality is related to the patient's comorbid conditions and not to the procedure.

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참고문헌

  1. Peters B, Ewert P, Berger F. The role of stents in the treatment of congenital heart disease: current status and future perspectives. Ann Pediatr Cardiol 2009;2:3-23. https://doi.org/10.4103/0974-2069.52802
  2. Baykan A, Karaqoz T, Celiker A. Endovascular stent implantation for coarctation of the aorta in children and young adults. Immediately follow-up results from Turkey. Turk J Pediatr 2009;51:116-9.
  3. Godart F. Intravascular stenting for the treatment of coarctation of the aorta in adolescent and adult patients. Arch Cardiovasc Dis 2011;104:627-35. https://doi.org/10.1016/j.acvd.2011.08.005
  4. Marshall AC, Perry SB, Keane JF, et al. Early results and medium-term follow-up of stent implantation for residual or recurrent aortic coarctation. Am Heart J 2000;139:1054-60. https://doi.org/10.1067/mhj.2000.106616
  5. Holzer R, Qureshi S, Ghasemi A, Lock JE. Stenting of aortic coarctation: acute, intermediate, and long-term results of a prospective multi-institutional registry-Congenital Cardiovascular Interventional Study Consortium (CCISC). Catheter Cardiovasc Interv 2010;76:553-63. https://doi.org/10.1002/ccd.22587
  6. Felts TF, Bacha E, Beekman RH 3rd, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011;123:2607-52. https://doi.org/10.1161/CIR.0b013e31821b1f10
  7. Ringel RE, Gauvreau K, Moses H, Jenkins KJ. Coarctation of the aorta stent trial (COAST): study design and rationale. Am Heart J 2012;164:7-13. https://doi.org/10.1016/j.ahj.2012.04.008
  8. Ou P, Mousseaux E, Celermajer DS, et al. Aortic arch shape deformation after coarctation surgery: effect on blood pressure response. J Thorac Cardiovasc Surg 2006;132:1105-11. https://doi.org/10.1016/j.jtcvs.2006.05.061
  9. Forbes TJ, Garekar S, Amin Z, et al. Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: a multi-institutional study. Catheter Cardiovasc Interv 2007;70:276-85. https://doi.org/10.1002/ccd.21164
  10. McCrindle BW, Jones TK, Morrow WR, et al. Acute results of balloon angioplasty of native coarctation versus recurrent aortic obstruction are equivalent. Valvuloplasty and Angioplasty of Congenital Anomalies (VACA) registry investigators. J Am Coll Cardiol 1996;28:1810-7. https://doi.org/10.1016/S0735-1097(96)00379-8
  11. Forbes TJ, Kim DW, Du W, et al. Comparison of surgical, stent, and balloon angioplasty treatment of native coarctation of the aorta: an observational study by the CCISC (Congenital Cardiovascular Interventional Study Consortium). J Am Coll Card i o l 2011;58:2664-74. https://doi.org/10.1016/j.jacc.2011.08.053
  12. Harrison DA, McLaughlin PR, Lazzam C, Connelly M, Benson LN. Endovascular stents in the management of coarctation of the aorta in the adolescent and adult: one year follow up. Heart 2001;85:561-6. https://doi.org/10.1136/heart.85.5.561
  13. Mullen MJ. Coarctation of the aorta in adults: do we need surgeons? Heart 2003;89:3-5. https://doi.org/10.1136/heart.89.1.3
  14. Turner DR, Gaines PA. Endovascular management of coarctation of the aorta. Semin Intervent Radiol 2007;24:153-66. https://doi.org/10.1055/s-2007-980052
  15. Forbes TJ, Moore P, Pedra CA, et al. Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta. Catheter Cardiovasc Interv 2007;70:569-77. https://doi.org/10.1002/ccd.21191
  16. Chen SS, Donald AE, Storry C, Halcox JP, Bonhoeffer P, Deanfield JE. Impact of aortic stenting on peripheral vascular function and daytime systolic blood pressure in adult coarctation. Heart 2008;94:919-24. https://doi.org/10.1136/hrt.2006.109389